Kornimate/medical-research-clean huggingface dataset:
erector spinae block with ropivacaine and dexmedetomidine on opioid consumption after lumar spine surgeries

Conditions: Postoperative Pain

Summary: the aim of this study is to investigate the role of 0.5 micrograms/kg of dexmedetomidine with 0.2 % ropivacaine in erector spinae block in reducing opioid consumption for patients undergoing lumbar spine surgeries. this study will help in understanding the role of adding dexmdetomidine to ropivacaine in erector spinae block in reducing opioid consumption after lumbar spine surgeries

a number of adjuvants have been used with local anesthetics including dexamethasone, nalbuphine and dexmedetomidine etc with the aim of improving quality and duration of peripheral nerve blocks. dexmedetomidine is a potent alpha-2 agonist which can prolong the duration of regional anesthesia block when used in combination with local anesthetics. although, there is no consensus on the dose of dexmedetomidine for peripheral nerve block considering the fact that it can lower heart rate and blood pressure intraoperatively. investigators therefore, planned this randomised controlled trial to investigate the role of 0.5 micrograms/kg of dexmedetomidine with 0.2 % ropivacaine in erector spinae block for patients undergoing lumbar spine surgeries.

Eligibility criteria:
inclusion criteria: * patients aged between 18 and 70 years, scheduled to undergo lumbar spine surgeries with an asa score of 1 to 3 will be included in the study exclusion criteria: * patients who refused enrollment or later requested removal for the study, those who are unable to give informed consent and patients with either contraindications for regional anesthesia, known allergy to local anesthetics or dexmedetomidine, bleeding diathesis, use of anticoagulants or corticosteroids, inability to operate patient controlled analgesia (pca) system, psychiatric disorders or use of psychiatric medications will not be included in the study.
outcomes of meniscus root repair using a transtibial pullout technique

Conditions: Meniscus Tear

Summary: the results of this study will optimize the care for patients with a meniscus root tear. surgeons will be able to determine if mrr (meniscus root repair) with transtibial pullout technique is an effective treatment and will identify potential risk factors for poor clinical outcomes. in addition, investigators will determine if mrr is successful in delaying the radiographic progression of arthritis in the involved compartment.

the loss of attachment at the root of the meniscus impairs the ability to maintain hoop strain when the tibiofemoral joint is loaded. this loss of hoop strain is responsible for the increased pressure on the articular cartilage. this new awareness has prompted surgeons to consider surgical repair for treatment of meniscal root avulsions. despite this recent focus on results of surgical repair, prospective studies are lacking, and the optimal surgical indications and technique have not been optimized.

Eligibility criteria:
inclusion criteria: 1. meniscus root avulsion tear (defined as meniscus posterior horn root avulsion or full thickness tear within 9 mm of the root attachment) 2. age 18-65 3. ligament injury with concomitant reconstruction is acceptable 4. malalignment with corrective osteotomy is acceptable exclusion criteria: 1. subchondral collapse on pre-op mri 2. extrusion greater than 3 mm 3. intra-op outerbridge grade 3 or greater chondromalacia 4. intra-op poor quality meniscus tissue 5. mal-alignment greater than 5 degrees without corrective osteotomy 6. obesity with bmi over 40 7. kellgren lawrence \> grade 2 8. worker's compensation status
grandaides; a workforce innovation to address post acute care

Conditions: Heart Failure

Summary: randomized controlled trial with two groups looking at post hospital care for patients who were admitted with congestive heart failure. the control group includes standard of care provided to the patients after discharge including a hospital employed community health worker. the intervention group receives a specially trained grandaide following the grandaide model for post acute care. difference in er visits and readmissions was measured.

grandaides program is a credible messenger community health worker based program that assumes a community health worker from the community who has specialized education around a certain chronic condition will be able to support patients in the outpatient setting more effectively than current standard of care. in this study a grandaide visited a patient discharged from the hospital in their home for 4 weeks providing education, checking vital signs, and assisting with communication with the cardiologist. the study measured the difference in hospital admissions and er visits between the group that was assigned a grandaid and the group that took part in standard care. the groups were assigned randomly. the difference was calculated using one and two tailed t-test results.

Eligibility criteria:
inclusion criteria: clinical diagnosis of heart failure lives in 6 zipcode catchment area of temple university hospital is followed by temple cardiology exclusion criteria: end stage renal disease housed in a skilled nursing facility substance use disorder unable to give consent doesn't speak english under age 18
evaluation of changes in brain connectivity after tumor resection

Conditions: Brain Tumor

Summary: this study is being done to see the changes in structural and functional connectivity that happen in the brain of patients undergoing brain tumor surgery.

the purpose of this study is to visualize and quantify changes in the brain of patients undergoing brain tumor surgery through high-quality, high-resolution structural and functional brain imaging and brain connectivity measures. to understand the effects of the primary treatment for brain tumors, the investigators will determine changes in brain connectivity after surgery and correlate this with neurologic status. the investigators will prospectively collect brain imaging (mri) and clinical data in brain tumor patients before and after removal of their tumor. any adult patient with a brain tumor (primary or metastatic) for whom surgery to remove the tumor is planned is eligible. the investigators plan for recruitment of 30 subjects. this will include 27 subjects with brain tumors and 3 healthy controls. both clinical and imaging data will be collected for tumor and healthy subjects. a two-part research scan (diffusion mri and resting state functional mri) will be performed within 1 week prior to surgery and again 2 weeks after surgery. the healthy controls will obtain identical research scans with the second session two weeks following the first session. subjects will be also administered neurocognitive and qualitative assessments at two time intervals, pre- and post-surgery (2 weeks).

Eligibility criteria:
inclusion criteria: 1. brain tumor subjects (27) * informed consent * age equal to or greater than 19 years (age of majority in nebraska) * brain tumor that requires surgery * primary or metastatic brain tumor 2. healthy subjects (3) * informed consent * age equal to or greater than 19 years (age of majority in nebraska) * healthy subject with no know neurocognitive deficiencies exclusion criteria: * any contraindication to mri (i.e. implanted devices) * inappropriate body habitus for mri * no capacity to understand the study the study or consent to it * positive pregnancy test in females * end stage renal disease or severe renal dysfunction * severe anxiety disorder * metabolic encephalopathy * significant medical co-morbidities precluding a safe surgery * need for sedation for mri
provider-patient communication coaching

Conditions: Provider Burnout; Communication

Summary: to examine the effect of a coaching intervention on provider burnout and communication

the investigator will recruit providers at duke university and randomly assign them to receive (1) a communication coaching intervention or (2) a waitlist intervention. the investigator will survey all providers at baseline and follow up. providers randomized to the intervention arm will attend face-to-face meetings with study coaches, and have some of their encounters with patients shadowed by a coach or audio recorded. providers will obtain verbal consent from patients to participate in the study (i.e. have their encounter shadowed or audio recorded). providers will then be provided feedback by coaches on their communication during these encounters. providers randomized to the waitlist intervention arm will be offered the option of receiving this intervention after they complete the follow up survey.

Eligibility criteria:
inclusion criteria: * providers and patients at duke university medical center exclusion criteria: * younger than 18 * non-english speaking

Keywords: provider-patient communication coaching feedback burnout
effectiveness of small bowel decompression techniques in patients with small bowel obstruction

Conditions: Small Bowel Obstruction; Small Bowel Obstruction Adhesion; Small-Bowel Obstruction Due to Volvulus; Hernia Incarcerated

Summary: this study will compare results of different intestinal decompression techniques in patients with small bowel obstruction.

taking into account the large number of different variations of intestinal decompression methods, a comparative analysis will be carried out based on one comparison group (i) and three main ones (ia-b). the comparison criterion will be a group of patients with nasogastric drainage as the only method of the gastrointestinal tract decompression during surgery and in the postoperative period. in the main groups more active methods of intestinal decompression will be performed, including drainage of the initial parts of the small intestine or total intubation, both single-stage intraoperative and its extended version

Eligibility criteria:
inclusion criteria: * acute adhesive intestinal obstruction, including strangulation forms; * incarcerated ventral hernias, accompanied by impaired intestinal passage; * acute adhesive intestinal obstruction in the hernial sac; * obstruction of the small intestine lumen with gallstones and other foreign bodies. exclusion criteria: * with peritonitis and other complicated surgical infection; * operations with intestinal resection; * patients after laparostomy

Keywords: acute intestinal obstruction, small bowel obstruction, nasointestinal tube, nasogastric tube
low energy dissection vs. electrocautery in lumpectomy shaved surgical margins

Conditions: Breast Cancer Female

Summary: the purpose of this study is to compare the qualitative severity and depth of dissection devices' associated thermal artifact in breast lumpectomy shaved margins between the use of electrocautery and low thermal energy dissection, photonblade. the investigators hypothesize that the use of photonblade would result in a significantly lower qualitative severity and a shorter depth of thermal artifact in breast lumpectomies shaved margins, when compared to electrocautery devices.

when performing lumpectomy, surgeons have used electrocautery devices as dissecting tools. however, those devices use high thermal energy that might impact the margin cellular architecture and as such the quality of margin assessment by the pathologist. moreover, recently, modern low thermal energy dissection devices have been introduced to the market. however, the impact of those devices on reducing the thermal injury/artifact on surgical margin has not been well investigated. 4,5 while ruidaz et al. 2011 data suggest that using the traditional electrosurgical device in place of the low thermal-injury device results in 48% of the close margin samples being negatively converted to false-positive, and in 11% converting from close to false-negative, there is still a need for more studies to further characterize the utility of those devices. 6 photonblade (invuity, san francisco, ca, usa) has been approved by united states food and drug administration (fda). photonblade is a dynamic precision illuminator with enhanced energy delivery dissection device. the dynamic precision illumination is a thermally cool illumination technology that allows a uniformal illumination without glare or shadow. 7 the enhanced energy delivery technology allows low thermal spread, surgeon controlled edge temperature, and wet field use.7 as such, phontonblade allows better blade control for achieving adequate visualization, hemostasis, with a minimum collateral damage to the surgical margin tissue. the use of photonblade demonstrated the least penetrating thermal tissue damage/spread when compared to other modern dissection devices (valleylab pencil, valleylab edge coated pencil, plasmablade 3.0s and plasmablade 4.0).8

Eligibility criteria:
inclusion criteria: * have aged 18 years old or older. * have dcis or invasive breast cancer that is eligible for breast-conserving surgery. * have not had previous chest radiotherapy. * understand the study purpose, requirements, and risks. * able and willing to give informed consent. exclusion criteria: * none
comparison of the effects of virtual balance training and conservative rehabilitation therapy in stroke patients

Conditions: Hemiplegia; Stroke

Summary: the study aimed to assess the effects of a virtual balance training program using the thera-trainer balo (ttb) device along with conservative rehabilitation program on the clinical findings; standing, stepping, walking and balance measures; and activities of daily living in patients with stroke.

stroke is one of the leading causes of death and disability worldwide. approximately 71% of stroke cases occur as a result of ischemic infarcts. most survivors of stroke experience gait and balance disorders that increase the risk of falling. it has been shown that the functional recovery of patients with stroke is adversely affected and length of hospital stay during the rehabilitation program, particularly in those with severe balance disorders. virtual reality technologies are currently employed to accelerate functional recovery in patients. a total of 30 patients were included in the study. the patients were randomized into two groups with 15 patients in each group by simple randomization. group 1 received the conservative rehabilitation program, whereas group 2 received a balance training program using the thera-trainer balo (ttb) device along with the conservative rehabilitation program. patient information regarding the age, gender, hemiplegic side, stroke duration, and type of ischemia were recorded. the stage of motor recovery according to brunnstrom, spasticity based on the modified ashworth scale, ambulation ability based on the functional ambulation scale (fas), quality of life based on the short form-36 (sf-36) scale, and balance-coordination status based on the berg balance scale (bbs) were assessed at the beginning of the treatment and at the endpoint of the 8 week treatment. moreover, evaluations were made with static and dynamic postural stability tests. the study aimed to assess the effects of a virtual balance training program using the thera-trainer balo (ttb) device along with conservative rehabilitation program on the clinical findings; standing, stepping, walking and balance measures; and activities of daily living in patients with stroke.

Eligibility criteria:
inclusion criteria: * patients who had a cerebrovascular accident at least 6 months before the study, * patients had the first unilateral hemiparesis attack, could stand with or without assistance, * patients had no contraindications for walking. exclusion criteria: * patients with a history of neurological diseases, * a mini-mental test score of \<24, * severe spasticity at the lower extremity with grade 4 and unilateral neglect, and musculoskeletal diseases such as amputation and severe arthritis, which limits walking,
hallux mobilization in patients with parkinson's disease

Conditions: Parkinson Disease

Summary: parkinson's disease is a degenerative disorder of the central nervous system. the motor symptoms of parkinson's disease result from the death of dopamine-generating cells in the substantia nigra, a region of the midbrain; the cause of this cell death is unknown. early in the course of the disease, the most obvious symptoms are movement-related; these include shaking, rigidity, slowness of movement and difficulty with walking and gait. a multidisciplinary intensive rehabilitation treatment (mirt) is able to improve different parameters in pd that are poorly responsive to dopaminergic therapy. in this study, we aim to understand whether the passive mobilization of the metatarsophalangeal joint of the hallux determines an increase in the joint range in this district, allowing to improve, at least, the gait.

parkinson's disease is a degenerative disorder of the central nervous system. the motor symptoms of parkinson's disease result from the death of dopamine-generating cells in the substantia nigra, a region of the midbrain; the cause of this cell death is unknown. early in the course of the disease, the most obvious symptoms are movement-related; these include shaking, rigidity, slowness of movement and difficulty with walking and gait. the main families of drugs useful for treating motor symptoms are levodopa dopamine agonists and monoamine oxidases-b inhibitors.a multidisciplinary intensive rehabilitation treatment (mirt) is able to improve different parameters in pd that are poorly responsive to the pharmacological therapy. in this study, we aim to understand whether the passive mobilization of the metatarsophalangeal joint of the hallux determines an increase in the joint range in this district, allowing to improve, at least, the gait in patients with pd. in this course, we will evaluate whether passive mobilization of this joint, lead to positive effects on the freezing of gait and on the festination.

Eligibility criteria:
inclusion criteria: pd patients stage 3 h\&y with fog exclusion criteria: we excluded patients with atypical parkinsonism, with other concomitant neurological conditions (with cerebrovascular etc.), with joint disorders, muscle disorders or with other orthopedic conditions.

Keywords: gait disturbances metatarsophalangeal joint
desmopressin for improving nocturnal enuresis in patients after radical cystectomy with bladder reconstruction

Conditions: Nocturnal Enuresis

Summary: the purpose of this study is to prospectively assess whether desmopressin, given for a period of month to patients after radical cystectomy with orthotopic bladder reconstruction, improves and lowers the rate of nocturnal enuresis.

we will prospectively assess the utilization of desmopressin in improving nocturnal enuresis in patients after radical cystectomy with orthotopic bladder reconstruction. patients after radical cystectomy with neobladder reconstruction will be given desmopressin 0.1 mg once a day for a duration of one month. before beginning treatment patients will be given the nnes-q questionnaire to assess severity of nocturnal enuresis. at the end of treatment, the same questionnaire will be given to all patients to assess if nocturnal enuresis improved. sodium levels will be tested before treatment, 2 weeks after beginning treatment and at the end of treatment.

Eligibility criteria:
inclusion criteria: * age above 18 * able to give informed consent * patients afte radical cystectomy with orthotopic bladder reconstruction with night time incontinence exclusion criteria: * patients with after radical cystectomy with orthotopic bladder reconstruction with daytime urinary incontinence * patients already treated with desmopressin due to other reasons. * patients with an allergy or insensitivity to desmopressin. * patients with known hyponatremia * patients with severe chronic renal failure and creatinine clearance of below 50 cc/sec. * patients with severe congestive heart failure * patients with active urinary tract infection * patients taking drug therapy which can interact with desmopressin and affect it's action.examples include diuretics, tricyclic antidepressants, carbamezapine and chlorpropamide and indomethacin. * patients with an indwelling urinary catheter.
organ dysfunction change in acute necrotizing pancreatitis patients with sepsis after open necrosectomy

Conditions: Necrotizing Pancreatitis

Summary: the purpose of this study is to characterize organ dysfunction change in acute necrotizing pancreatitis patients with sepsis after open necrosectomy.

before surgery, study participants will be asked questions about age, gender, education level, etc. study participants will also be questioned regarding pancreatic symptoms, as measured on the patient-reported outcome scale in acute pancreatitis (including, pain, abdominal distention, eating, bowel movements, nausea and vomiting, thirst, and weakness). organ dysfunction was defined according to the sequential organ failure assessment (sofa) score. the sofa score will be measured at preoperative (t1), postoperative day 1 (t2), postoperative day 3 (t3), postoperative day 7, or at hospital discharge, whichever comes first (t4). following discharge from the hospital, study participants will be contacted at 1 month, 3 months, 6 months, and 1 year after surgery, and asked to complete a survey about their pancreatic symptoms and survival status after surgery.

Eligibility criteria:
inclusion criteria: 1. patients 18 years or older 2. diagnosis of acute pancreatitis according to the revised atlanta classification, requires two of the following three criteria: (a) typical abdominal pain, (b) an increase in serum amylase or lipase levels higher than three times the upper limit of normality, and (c) signs of ap in imaging 3. patients with confirmed or suspected infected pancreatic or peripancreatic necrosis were scheduled for open necrosectomy 4. meet sepsis-3 criteria exclusion criteria: 1. patients refuse to participate 2. patients undergo repeat surgery on the same site

Keywords: acute necrotizing pancreatitis sepsis organ dysfunction
follow-up at school-age of children who participated in the efficacy study of nitric oxide for premature infants

Conditions: Prematurity, Respiratory Distress Syndrome,Hypoxemia

Summary: our previous data demonstrated that premature infants treated with inhaled nitric oxide at birth had improved neurodevelopmental outcomes at two years corrected age. we now wish to determine whether this benefit continues through school age.

two questionnaires (truncated versions of previously validated surveys), one for parent and another for teacher, for which written consent was previously obtained are being sent to parents. the teacher questionnaires will be delivered via parents. a clinic visit will accompany age appropriate neurodevelopmental examination, administration of the functional independence measure for children (weefim) survey, and hearing and visual screening exams (if appropriate).

Eligibility criteria:
inclusion criteria: * children who participated in nova study and are of school age exclusion criteria: * children who participated in nova study but deceased post discharge

Keywords: inhaled nitric oxide, lung recruitment, ventilatory approach, neurodevelopmental outcomes, school age children